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20.03.17

Providers warn achieving 2017-18 performance targets now ‘mission impossible’

Reaching hospital performances targets has been described as “mission Impossible” by NHS Providers in a report released today, as the organisation also called for “realism, flexibility and support” in the NHS’s approach to performance figures.

In its analysis of NHS figures and targets, NHS Providers found that targets for 2017-18 are out of reach for the health service, as it revealed there was an increasingly “unbridgeable gap” opening up between targets and low levels of funding.

The review also went on to set out the biggest challenges facing the NHS over the next financial year, including absorbing a projected 3.1% increase in overall demand from patients and a 2.1% increase to costs like pay, buildings and laboratories.

NHS Providers also estimated that the extra cost of delivering key performance targets in areas such as A&E and routine operations came to a staggering £2.4bn – £3.1bn in the next year.

The organisation warned that the combination of these elements against a sharp reduction in NHS funding increased – down from 3.6% to 1.3% in 2017-18 – meant that meeting targets with limited resources was turning into a completely unattainable task.

The risk this problem poses to patient safety is also considerable. The report found that on the current performance trajectory, next year 1.8 million people in A&E services would fall outside of the target of 95% of patients being seen in four hours – over half a million people more than this year.

On top of this, 100,000 more people will wait longer for routine surgery, which is up 150% compared to 2016-17.

According to Chris Hopson, CEO of NHS Providers, the report’s findings show that now is the time “to sit up and listen” to concern being voiced by care providers.

“It is unprecedented for us to warn the NHS will not be able to deliver on its commitments before the financial year has even started,” he said.

“But trusts are currently being asked to absorb a 5% plus cost and demand increase, recover the four A&E wait and 18-week surgery targets, improve care for cancer and mental health and balance next year’s books financially.”

The combination of trying to reach these targets in addition to funding reductions is something that is now “mission impossible”, Hopson explained.

“The numbers don’t add up,” he claimed. “NHS trusts want to deliver NHS standards, achieve financial balance and improve performance. The standards on A&E and surgery were set for a good reason – they are a good proxy for the quality and access to care the NHS should provide. But trusts can only deliver if funding keeps pace with rapidly rising demand.”

Without an increase in funding, “greater realism, flexibility and support” was required from leaders of the service to ensure future targets are met.

“Trusts won’t be able to recover the A&E and elective surgery targets across the whole year. Just stabilising the rapidly increasing performance decline would be an achievement in itself,” added Hopson.

“Given that demand and cost increases will easily outstrip funding and efficiency increases, just reproducing this year’s financial performance is a stretching target.

Hopson went on to recommend that money was redirected to frontline care, to reduce “unwarranted variation” in performances across the NHS and to improve performance rapidly.

He concluded: “There is also a very clear and simple warning in our analysis. We have now reached the point where, on the resources available, NHS trusts can no longer deliver what the NHS constitution requires.”

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22/03/2017New additions and unexpected announcements

As NHE went to press, many of us were still recovering from the chancellor’s unexpected health announcements in his last Spring Budget.   While the sector welcomed Philip Hammond’s revelations, centered on capital funding for advanced sustainability and transformation plans (STPs) and A&E triage schemes (page 24), the government failed to address the funding gap still facing the NHS.   Even the £2bn social care windfall, which Treasury has... read more >